Health
GLP-1s can help address LGBTQ healthcare barriers: experts
Queer people more subject to body dissatisfaction
Dana Piccoli tried everything to lose weight.
She frequented the gym, went on and off diets and hired a personal trainer. When Piccoli decided to get on a GLP-1, it wasn’t a “short cut” to drop weight – it was a way for her to live her life comfortably.
“When I told someone I was on it, they were like, ‘I’m going to the gym because I want to do it the right way,’” said Piccoli, managing director of queer media collaborative News is Out. “Obviously that kind of stung because for me, this is the right way.”
GLP-1 drugs have caused quite a stir since becoming more integrated into mainstream medicine. The newness of some brands, like Ozempic, have led to stigmas and mistrust surrounding them. These stigmas disproportionately affect the LGBTQ+ community since queer people are more subject to body dissatisfaction and have more trouble finding accessible healthcare.
Through all the noise, however, experts say taking GLP-1s are safe with the right counseling, and LGBTQ+ people could largely benefit from them.
So, what’s all the ruckus about? Are GLP-1s an “easy way out” to lose weight? And how do they really impact the LGBTQ+ community?
How GLP-1s work
GLP-1s, or glucagon-like peptide-1, mimic the actions of a GLP-1 that is released by the gut after eating. It can help people with Type-2 diabetes by lowering blood sugar through the release of insulin, and can help those with obesity by slowing down digestion and, in turn, reducing one’s appetite.
Like any medication, there are some side effects to consider. Sangeeta Kashyap, assistant chief of clinical affairs at Weill Cornell Medicine, said symptoms like nausea, diarrhea, and vomiting can occur. However, Kashyap said these side effects are less severe than past GLP-1 brands – a reason that contributes to their newfound popularity – and can be better managed with proper guidance.
Since the drug causes a loss of both fat and muscle loss, she said doctors should inform patients to do strength training to maintain any deteriorating muscle, and to eat high-protein diets, since fatty foods increase the risk of vomiting or nausea.
Getting on a GLP-1 isn’t just about shedding a few pounds. Kashyap said it’s a commitment to your health and body, which is why talking with a doctor and understanding the risks are crucial.
“We give patients appropriate guidelines,” Kashyap said. “We do blood tests, we monitor things, and give a lot of counseling to these patients. I don’t think you could just give the medicine out like candy.”
Piccoli, who started her GLP-1 journey with her wife, said the medication helped turn off “food noise.”
“Your motivation for things, your reward system with food is kind of disabled,” Piccoli said. “That really helped me understand my relationship with food.”
Turning down food noise
Losing weight isn’t as easy as getting on a GLP-1 and eating less. Piccoli said turning off the food noise in her brain led to a complete lifestyle shift.
“I had to completely change everything about the way I eat, everything about the way I approach food,” she said about her experience taking Mounjaro. “This has been one of the hardest things I’ve ever done.”
Kashyap said the lifestyle change that comes with taking a GLP-1 is why it’s important to consult a doctor first to understand how it could affect you not just physically, but also emotionally.
Kashyap said she sees higher rates of mental health disorders in transgender women, a community that already faces more barriers in finding accessible healthcare.
This could lead to someone getting on the drug for the wrong reasons, Kashyap said. She noted that those with eating disorders or body dysmorphia could face more severe side effects. Body dysmorphia and body image concerns are already an issue for the LGBTQ+ community, Kashyap said, so prescribing GLP-1s needs to be handled with care.
One way to ethically prescribe a GLP-1 to a patient would be to conduct a mental health screening, according to Kashyap. Mental health screenings aren’t required to get on a GLP-1, but Kashyap said they would be beneficial to patients who may be prone to negative effects by taking the drug.
Although some people may see more severe side effects, Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital, said GLP-1s are a completely safe and rigorously tested drug.
If a person faces negative side effects from taking a GLP-1, it’s more about how their body or brain is reacting to it than the drug itself being unsafe.
“Any kind of weight loss is going to affect your mood, either positively or negatively,” Apovian said.
With the queer community already facing increased barriers to healthcare, there’s another issue to consider: GLP-1s aren’t cheap.
Depending on where you get it from and whether or not insurance covers it, you could pay hundreds or even thousands of dollars for a limited supply.
Piccoli said she paid out of pocket and had to make sacrifices for her and her wife to both get on a GLP-1.
“I didn’t renew my car lease,” Piccoli said. “We decided to go down to one car so that we had some extra income monthly to be able to pay for it.”
On the other hand, Matt, who requested to be identified only by his first name due to the sensitivity of the topic, said he was shocked at how easy it was to get the cost of his GLP-1 covered by insurance. He had been warned by his doctor about the difficulty of getting it covered, and expected an “uphill battle.”
“[My doctor] wrote out the prescription for me, and on my way home, I got a text message from the drugstore saying it was ready to go,” said Matt, who’s lost 48 pounds on Ozempic since June 2024.
Matt said experiences like his, although not the standard, are why it’s important to talk with your doctor about getting on a GLP-1 and see for yourself rather than taking advice from social media stigmas.
Kashyap said the drug is also becoming more accessible through websites like Lilly, which provide vials for about $300-500. While that isn’t pocket change, it’s significantly cheaper than retail pharmacies.
You may have to make sacrifices like Piccoli did, but getting access to modern GLP-1s for weight loss isn’t only for the Hollywood elites like it seemed to be a few years ago.
Through all the social stigmas and uncertainty, Kashyap and Apovian agreed that GLP-1s are a major benefit for the queer community.
Trans women have increased rates of obesity, Type-2 diabetes and metabolic syndrome, according to Kashyap. Estrogen treatments increase fat mass and insulin resistance, leading to higher obesity rates in trans women. Kashyap said GLP-1s could be helpful in mitigating those effects.
GLP-1s also reduce alcohol cravings, so Kashyap noted that anyone struggling with alcoholism may see improvements with that condition upon getting on the drug.
Getting on a GLP-1 isn’t the walk in the park some may make you believe it is – it’s a lifestyle change and health commitment.
But it’s also a change that can provide good and healthy results if you seek the appropriate guidance from a professional.
While social stigmas in the queer community may lead to misinformation on who should use it and what it should be used for, GLP-1s are safe and can be a much-needed relief for a community facing significant healthcare obstacles.
Health
CVS Health agrees to cover new HIV prevention drug
‘Groundbreaking’ PrEP medication taken by injection once every six months
CVS Health, the nation’s second largest pharmacy benefit manager company that plays a key role in deciding which drugs are covered by health insurance policies, has belatedly agreed to cover the new highly acclaimed HIV prevention drug yeztugo.
The U.S. Food and Drug Administration approved the use of yeztugo as an HIV prevention or “PrEP” medication in June 2025 as the first such drug to be taken by injection just once every six months. AIDS activists hailed the drug as a major breakthrough in the longstanding effort to end the HIV epidemic.
“We are pleased that CVS Health has finally decided to cover this groundbreaking new PrEP mediation,” said Carl Schmid, executive director of the HIV+ Hepatitis Policy Institute.
“Four months ago, 63 HIV organizations joined us in sending a letter to CVS’s president urging them to reconsider their refusal to cover Yeztugo and reminding them of their legal obligation to cover PrEP and describe the important benefits the drug would bring to preventing HIV in the U.S.,” Schmid said in a statement.
He noted that CVS Health now joins other leading pharmacy benefit manager companies and insurers in covering yeztugo. Gilead Sciences, the pharmaceutical company that developed and manufactures yeztugo, has said 85 percent of all people with health insurance in the U.S. now have coverage for the drug, according to Schmid.
“However, coverage does not automatically translate into access and usage,” Schmid said in his statement. “Too many people are being forced to pay copays while other payers, including employers, are failing to cover all forms of PrEP,” he said.
According to Schmid, the HIV+ Hepatitis Policy Institute is joining other HIV advocacy organizations in urging federal and state government officials to engage in “aggressive enforcement of PrEP insurance coverage requirements and sustained funding of state, local, and community HIV prevention programs.”
Health
Choose U ambassadors share lived experiences with HIV, personal reflections, and insights
The Choose U World AIDS Day panel brought together three longtime advocates living with HIV to talk about care, stigma, and what living with HIV over the long-term means to them. The conversation featured Jahlove Serrano, Joyce Belton, and Andrew Nichols, who have each lived with HIV for more than 20 years. News is Out hosted the event in partnership with Gilead Sciences.
“Co-created with community representatives from around the world, Choose U is comprised of inspiring examples of how the outlook for aging with HIV has dramatically changed,” Gilead shared in the recent launch of the program. “By focusing on the real-world experiences of people in different circumstances, Choose U spotlights individuals prioritizing starting and staying on HIV treatment, self-care, and overall strategies to help them lead healthier lives.”
The Choose U ambassadors opened with a clear message: Lived experience drives understanding.
Each panelist talked through the decisions, relationships, and periods of uncertainty that shaped their HIV care. They also described their approaches to HIV treatment and adherence, including the importance of staying on treatment to help lower the risk of HIV drug resistance. They reflected on the shifts they have seen in HIV treatment over the decades, the value of honest conversations with providers, and how staying engaged in care and on HIV treatment helped them lead longer, healthier lives.
The panel discussed U=U, which stands for “Undetectable equals Untransmittable.” Undetectable means there is so little virus in the blood that a lab test can’t measure it. Research shows that taking HIV treatment as prescribed, and getting to and staying undetectable, prevents HIV from spreading through sex.
The panelists also spoke about the emotional side of living with HIV over the long-term and the stigma they have faced. Joyce described a personal moment when her pastor visited her in the hospital and how that experience began her work educating her church community about HIV.
Jahlove talked about how his biological family reacted to his diagnosis. “When I disclosed my status, they told me that I put a shame on the family,” said Jahlove. When he shared his status with his peers, they responded with support, which gave him a sense of empowerment.
Andrew, a professional therapist, described how he has experienced stigma in dating and in his workplace, and why he turns to therapy for guidance. “Therapy has really helped me rebuild my confidence and realize my self-worth has to come from me,” said Andrew. “Then after that, I can help with the greater community.”
The panel closed with a message for others living with HIV: They encouraged viewers to start and stay engaged in HIV treatment and care, ask questions, and rely on supportive networks. Their stories show how starting and staying on treatment over the long-term, community, and affirmation can shape well-being.
A recording of the full 30-minute event is now available on YouTube, which you can access here.
Health
The harsh truth about HIV phobia in gay dating
HIV and stigma remain baked into queer dating culture
Uncloseted Media published this article on Dec. 9.
This story was produced with the support of MISTR, a telehealth platform offering free online access to PrEP, DoxyPEP, STI testing, Hepatitis C testing and treatment and long-term HIV care across the U.S. MISTR did not have any editorial input into the content of this story.
By SAM DONNDELINGER | In his room, 19-year-old Cody Nester toggles between Grindr profiles on his phone.
As he senses chemistry with a match, he knows he has to flag something that could be a deal breaker.
“Did you see on my profile that I’m HIV positive?” he writes.
The reply arrives instantly.
“You’re disgusting. I don’t know why you’re on here.” Seconds later, the profile disappears, suggesting Nester is blocked.
“He went out of his way to say that. People could at least be more aware, ask questions, and understand the reality [of living with HIV] instead of attacking us,” Nester told Uncloseted Media.
“I would say 95 percent of people respond that way,” says Nester, who lives in Hollywood, Fla., and works at a Mexican restaurant. “The entire conversation is going fine. They’re down to meet up and then right when I mention [HIV], it’s always, ‘Oh no, never mind.’”
Some other messages he’s received include:
“You’ll never get anything in your life.”
“Why don’t you die?”
“Why are you on here?”
More often, it’s silence, a cold “No” or a sudden block.
“It’s like you’re a white fish in a school of black fish,” he says. “You’re immediately the odd one out.”
Even though Nester’s undetectable status makes it impossible for him to transmit HIV to partners during sex, he experiences stigma around HIV, something which nearly 90 percent of Americans agree still exists, according to a 2022 GLAAD report. And a survey shared in 2019 found that 64 percent of respondents would feel uncomfortable having sex with someone living with HIV, even on effective treatment. The emotional cost of this stigma is a significant barrier to intimacy and can result in a loss of self-esteem, fear of disclosure and suicidal thoughts.
What the science says — and why it doesn’t seem to matter
“The fear comes from antiquated ideas around HIV,” says Xavier A. Erguera, senior clinical research coordinator at University of California, San Francisco,’s Division of HIV, Infectious Diseases & Global Medicine. “A lot of people who are newly diagnosed still fear it’s a death sentence. Even though we have medications now to treat it effectively, and it’s basically a chronic condition, people haven’t caught up.”
Since 1996, antiretroviral therapies have developed to where they can suppress the virus to levels so low that it is undetectable in the blood, and thus not able to be transmitted to sexual partners. This is known as Undetectable = Untransmittable, or U=U. According to a Centers for Disease Control and Prevention report from 2024, 65 percent of HIV-positive cases are virally suppressed.
Another line of defense is pre-exposure prophylaxis (PrEP), which reduces the risk of acquiring HIV from sexual intercourse by roughly 99 percent when taken as prescribed. Approved by the Food and Drug Administration in 2012, the medication launched as a once-a-day pill and was hailed as a breakthrough as it transformed the sex lives of gay men, which had been shaped by decades of fear about HIV complications and about where AIDS came from.
“Internal logic doesn’t reflect what we know scientifically,” says Kim Koester, associate professor in the Department of Medicine at UCSF. “I was very optimistic when PrEP came out. The drug works, so why wouldn’t everyone use it?”
Even with PrEP use on the rise, less than 600,000 Americans used it in 2024, and Koester says skepticism and judgments about taking the drug persist.
“The phobia is pervasive,” Koester told Uncloseted Media. “People believe that others get the disease because of their lifestyle. … PrEP was supposed to be the antidote to the threat of HIV, reduce the anxiety, and make you more open to who you are and the sex you want. It’s supposed to be liberating. It is part of the answer. But it’s not enough. We don’t have enough people using PrEP for it to make the dent in the stigma we need.”
According to a 2023 study of seven informants living with HIV, public stigma stems from problematic views from society that those living with HIV are “a dangerous transmission source,” “disgraceful” and “violators of social and religious norms who have committed deviant behavior.”
Laramie Smith, assistant professor of Global Public Health at the University of California, San Diego, says this stigma is unwarranted and fueled by misunderstanding:
“With today’s treatments, it shouldn’t be a life-altering identity shift. It should be no different than, ‘I have diabetes.’ If you’re virally suppressed, it shouldn’t matter whether you’re friends with someone, whether you’re sleeping with someone — the science shows us that.”
How HIV phobia shows up online
Nester, who contracted HIV last year from a Grindr hook-up who insisted he was negative, says he is just starting to accept his diagnosis. “I didn’t go back on the apps for a long time after that. It messed with my mental health … realizing I’d have to take medication for the rest of my life.”
Since he started dating again this year, returning to apps like Grindr and Sniffies, he has faced a new normal. He tries to do everything “right” and disclose his status early. Even on his Grindr profile, he identifies as “poz,” slang for HIV-positive.
Still, he says most people ghost him once they find out. “The second I bring it up, it’s ‘No,’” says Nester. “The amount of discrimination you get … it’s always the same pattern. … People don’t know, and they don’t want to know. It messes with you.”
This discrimination may be fueled by a deprioritization of HIV awareness programs across the country. Earlier this month, the U.S. State Department did not commemorate World AIDS Day for the first time in 37 years. HIV prevention programs have been slashed, especially in conservative districts, and only 25 states and D.C. require both HIV and sex education. In many states, health curricula often lag behind current science and omit teaching about PrEP, gay sex and concepts like U=U. Research shows that Gen Z is currently the least educated generation about HIV.
“I could go all day explaining HIV, but people don’t want to listen,” says Nester, who is part of Gen Z. “People don’t want to learn about it; they just want to avoid it.”
HIV anxiety and public stigma shaped by history
Even in more progressive areas, stigma still exists. Damian Jack, a 45-year-old from Brooklyn, remembers sitting in an exam room in 2009 as a doctor explained how low his T-cell count was, which is a hallmark of HIV infection.
“I started hysterically crying,” he told Uncloseted Media. “HIV meant death. That’s what I thought.”
In 1981, when Jack was 1 year old, the first reports of a mysterious and deadly immune deficiency syndrome, which would later be named AIDS, appeared in the U.S. Growing up, Jack saw countless terrifying images of men on their deathbeds with Kaposi sarcoma, the purple lesions the media once called “gay cancer.” Public misinformation and fearmongering spread ideas that AIDS was a disease that “only gay men and drug users get.” And politicians often equated it with homosexuality and moral failure, calling it a “gay plague.” It wasn’t until September 1985, four years after the crisis began and thousands had died, that President Ronald Reagan first publicly mentioned AIDS.
Decades later, the emotional residue of that era and the shame associated with the virus lingers.
Hours after learning of his diagnosis, Jack faced his first encounter with rejection. He already had a date planned that night, and his doctor and friends encouraged him to go.
They had a great time until the date asked him: “Are you negative or positive?”
He told the truth.
“It was just understood there wouldn’t be a second date,” says Jack. “I remember thinking, ‘This is how dating is going to be now.’ I felt so anxious telling guys. It followed me everywhere. I don’t think that anxiety ever truly goes away.”
The emotional impact of HIV stigma
For those who are HIV-negative, experts say that “stigma’s whole design is to ‘other.’”
“The ‘us versus them’ creates that false sense of safety when it comes to HIV,” says Smith. “If I can believe that someone did something to deserve their diagnosis, and I’m not that [kind of person], then I’m safe.”
This othering is painful and can lead to shame, fear and isolation, and it is linked to a higher risk of depression and anxiety.
“If I’m undesirable, and that’s what those messages are communicating, that threatens your sense of safety, your sense of belonging and the fundamental desire we all have to be loved,” Smith says. “And that starts to reinforce the thinking that ‘I am not worthy. This virus that I have means that I’m not lovable. I am not safe showing up among other men.’”
“I pretend it doesn’t hurt, but some things do sting a little bit,” Nester says. “You start thinking, ‘Am I really that disgusting? Am I really that singled out?’”
When public stigma turns inward
“Internalized stigma is what occurs when applying the stereotypes about who gets HIV, the prejudice, the negative feelings, onto yourself,” says Smith.
In 2024, 38 percent of people living with HIV reported internalized stigma. And studies show that it can predict hopelessness and lower quality of life, even when people are engaged in care or virally suppressed.
Internalized stigma can also affect how people practice safe sex and communicate about the virus. A 2019 survey of men who have sex with men found that individuals who perceived greater community-level stigma were less likely to be aware of — and use — safer-sex functions available on dating apps, such as HIV-status disclosure fields, as well as sexual health information and resources.
“[HIV phobia] is probably the most intense, subvert bigotry I think you could experience,” Joseph Monroe Jr., a 48-year-old living in the Bronx, told Uncloseted Media.
On dating apps, men have messaged him things like, “You look like you’ve got that thing” and “Go ahead and infect someone else.”
Monroe has also dealt with misinformed people who rudely opine about how he contracted the virus: “Who fucked you? That’s how you got it, right?” people will say to him.
“You end up internalizing all these stereotypes about who gets HIV — that you were promiscuous, that you didn’t care about yourself, that you did something wrong,” says Smith. “You carry that in, and then you have to relearn: ‘No, I didn’t. This is just a health condition.’”
What HIV acceptance looks like and raising awareness
For those living with HIV, acceptance feels far away.
“You’re living under this threat of HIV and the threat that others find you threatening. It inhabits you socially and sexually,” Koester says. “People are hunkering down. Not putting themselves out there and having a mediocre quality of life. To have a sense of empowerment, you have to be legitimate and seen in the world and it’s hard to do that with the stigma that exists.”
Researchers say the path forward lies as much in conversation as in medicine.
Koester says she talks about HIV and PrEP anywhere she can, including in salons, cafes and restaurants. “Whenever I get into a cab with someone, I’m going to bring up HIV so the driver gets accustomed to hearing about it. … We have a long way to go in terms of exposure and awareness and every little bit helps.”
Part of this lies in increasing awareness through targeted marketing campaigns. PrEP is still profoundly misunderstood outside major urban centers, with uneven uptake among minority groups and usage gaps in the Bible Belt. And a 2022 U.S. survey found that 54.5 percent of people living with HIV didn’t know what U=U meant, and less than half of Americans agree that people living with HIV who are on proper medications cannot transmit the virus.
While eradicating stigma is slow, there is hope for acceptance.
Years after Jack’s diagnosis, in 2021, he told a man he was on a third date with that he was HIV-positive but undetectable. His date’s reply was almost casual:
“Oh — is that it? I thought you were going to say you had a boyfriend or something. I’m on PrEP. You’re fine.”
“It felt so good to hear him say that and accept me,” says Jack. “I was like, ‘This is my person. You’re my person.’” One year later, they got married.
Back in Florida, 19-year-old Cody Nester isn’t feeling this acceptance. He still scrolls past profiles that read “Only negative guys” and tries to ignore the hateful messages.
“It still hurts, but I know it’s coming from fear,” he says. “I wasn’t too informed about HIV before I got it. … When I got it, I really jumped into the rabbit hole and began to learn. I really do think [HIV and stigma] is because people are not knowledgeable. … When people don’t know details, they tend to get scared.”
Additional reporting by Nandika Chatterjee.
